“Touch and go”: Observational study of hand contact occasions in a Welsh (UK) food service business.

Introduction: Food service food handlers perform various daily operations, including handling of ready-to-eat (RTE) products, and must ensure food safety. Hands may serve as vectors of pathogen and allergen transfer; and therefore, it is essential to understand hand contact and hand hygiene behaviours in the food service environments to inform an accurate assessment of the cross-contamination risks for prevention of foodborne illness.

Purpose: To gain a systematic understanding of food handler bare hand contact with the items in food service environments, hand hygiene performance and the potential for cross-contamination of RTE products.

Methods: An observational case study was conducted in a multi-site SME food service establishment (25 employees), preparing and serving a variety of bakery products. CCTV video footage was captured from two sites (6 hours; 7 staff members). Hand contact occasions (n=1414) were coded and analysed using Observer XT Behaviour Analysis Software to quantify hand hygiene occasions, occasion sequences and probabilities of contact sequences with RTE products.

Results: Over a 6h period hand contact occasions were observed (site#1 (n=916); site#2 (n=498)). Food handlers touched raw products and ingredients (22% in site#1; 2% in site#2) and RTE foods (6% in Site#1;15% in Site#2). Only 6 compliant handwashing attempts were observed (4 on site#1; and 2- on site#2). Low to medium probability of contact with objects such as oven (20% in Site#1), till (23% in site#2), clothes (13% in Site#2) and face (11% in Site#2) not followed by handwashing and before touching RTE products was identified.

Significance: Study determined a lack of compliant handwashing prior to handling RTE foods, highlighting the need to raise food handler cross-contamination risk awareness. Findings could inform the food service sector recommendations regarding the need for appropriate hand hygiene behaviours and regular cleaning and sanitizing of hand contact surfaces; and the identification of surfaces for environmental and microbiological testing.